关键词: 胃癌, 程序性死亡配体-1, 缺氧诱导因子-1α, 临床病理特征, 预后

Abstract: Objective  To investigate the relationship between the expression of programmed death ligand 1(PD-L1) and hypoxia inducible factor-1α(HIF-1α) with the clinical pathological characteristics and prognosis of gastric cancer patients.Methods The cancer tissues of 100 gastric cancer patients who underwent radical gastrectomy at the First Hospital of Handan City from July 2019 to July 2020 were selected as the research subjects,and their adjacent tissues（normal tissues≥5cm from the cancer tissues） were as the control group.Immunohistochemical detection of PD-L1 and HIF-1α was performed by SP method.Spearman correlation analysis was used to analyze PD-L1 and HIF-1α in gastric cancer tissues.Kaplan-Meier method was used to analyze the 3-year survival relationship of gastric cancer patients.The influencing factors of prognosis and death in patients with gastric cancer were analyzed by univariate and multivariate Cox regression.Results  Among 100 gastric cancer patients,52 were PD-L1 positive and 48 were negative;67 were HIF-1α positive and 33 were HIF-1α negative,the positive expression rates of PD-L1 and HIF-1α in gastric cancer tissues were 52.00% and 67.00%,respectively,which were obviously higher than those in adjacent tissues(11.00%、18.00%)，the difference was statistically significant (P<0.05).Spearman correlation analysis showed that the expression of PD-L1 was positively correlated with that of HIF-1α in gastric cancer tissues (r=0.730, P<0.001). The expressions of PD-L1 and HIF-1α in patients with gastric cancer were correlated with TNM stage, lymph node metastasis and local invasion (P<0.05).The 3-year overall survival rate of gastric cancer patients was 48.00% after surgery, and the 3-years survival rate of patients with positive expression of PD-L1 and HIF-1α were 28.85% and 31.34%, which were lower than those of patients with negative expression of PD-L1 and HIF-1α (68.75% and 81.82%)(Log rank χ2=25.155,P<0.001.Log rank χ2=24.552,P<0.001).Moreover,positive expression of PD-L1 and HIF-1α,TNM staging of Ⅲ-Ⅳ,lymph node metastasis,and local infiltration were independent risk factors for prognosis and death in gastric cancer patients(P<0.05).Conclusion Both PD-L1 and HIF-1α are highly expressed in cancer tissues of gastric cancer patients,and they are positively correlated.They are also associated with clinical pathological features such as TNM staging,lymph node metastasis,and poor prognosis.

Key words: gastric cancer, programmed cell death ligand-1, hypoxia inducible factor-1, clinical pathological characteristics, prognosis